| NPI | 1639608441 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: VA 0401415656) |
| Additional Taxonomies | 122300000X Dentist (Licence: VA 0401415656) |
| 1223D0001X Dentist, Dental Public Health (Licence: VA 0401515656) | |
| Enumeration Date | 2017-06-06 |
| Last Update Date | 2022-02-19 |